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Alternative medicine attracts adherents for good or ill

By Bonnie Miller Rubin, Chicago Tribune reporter

August 21, 2013

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About 50 percent of Americans use alternative medicine — and 10 percent use it on their children, according to Paul Offit, author of the new book, "Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine." (HarperCollins).

Offit, chief of pediatric diseases at Children's Hospital of Philadelphia and professor of vaccinology and pediatrics at the University of Pennsylvania, examines why Americans are attracted to therapies and interventions of this loosely regulated, multibillion dollar industry that includes everything from acupuncture to dietary supplements. He also gets his fair share of hate mail from the anti-vaccine movement. Here's an edited transcript of what he had to say.

Q: Were you surprised to find that such a huge swath of the population has embraced alternative medicine?

A: Yes. It's seen as "the people's medicine." We can walk into any health-food store and get it. ... It's ours and no one can take it away from us. They don't ask: Does garlic really lower my cholesterol? Studies show that no form of garlic had any statistically significant effect on cholesterol, but people believe it because they want to believe it.

Q: But garlic certainly couldn't hurt someone. So what's the harm?

A: Because patients who choose garlic to treat their high cholesterol are choosing to do nothing for a problem that could lead to severe and even fatal heart disease. But when I challenge people, I get a lot of pushback.

Q: Why do you think so many consumers have embraced alternative medicine?

A: People are dissatisfied with conventional medicine, which is seen as distant and cold. They are in their doctor's office for a few minutes and walk out with a prescription. Chiropractors, homeopaths and acupuncturists spend more time with patients and imbue their practice with spirituality ... all of which is seen as endearing.

Q: As you did the research for this book, what was the biggest surprise?

A: How megavitamins can hurt you. A lot of people take megavitamins vastly in excess of the recommended daily allowance. For example, if you walk into a General Nutrition Center, you can buy a preparation of vitamin E that contains 3,333 percent of the recommended daily allowance. Almonds are a rich source of vitamin E. But you would have to eat about 1,700 almonds to get the equivalent of one capsule of the GNC prep. Although these products are often billed as "natural," this is not a natural thing to do. Same thing with 1,000 mg of Vitamin C — which is the equivalent of 14 oranges or eight cantaloupes. (This is a commonly available preparation.) If people thought of it in that way, they'd realize it's not a good thing…that anything at a high level can be harmful.

Q: Is there anything you changed your mind about in regards to these practices?

A: I didn't appreciate the value of the placebo response … that one can learn to release your own endorphins, can learn to upregulate and down regulate your own immune response, can learn to release your own dopamine … and that's quite valuable. One study performed by researchers at Johns Hopkins showed that military recruits were more likely to get influenza virus and shed virus for longer if they were relatively depressed. In other words, mood determined illness. In the writing of this book, I came to appreciate what we have referred to as placebo medicine as valuable. I just wish we had a different word for placebo. Because when people hear that word they think it's dismissive. That it's all just in their heads. But it isn't. It's real. It's physiological.

Q: Do any therapies or treatments work?

A: Melatonin can help with sleep. There are enough studies out there that show that St. John's wort can help with mild depression. It's all studiable … but most aren't studied. So if an "alternative" medicine works, it's not an alternative. It's medicine.

Q: Shifting gears, you are well-known for taking on the anti-vaccine crowd. For the first time, I have noticed the choice of checking "We do not immunize" on camp forms. I was surprised to see this presented as a viable option. Has the anti-vaccine movement moved into the mainstream?

A: Yes. I think that the choice not to get vaccines has become common enough to become dangerous. More and more people consider vaccines to be an option. And we're seeing greater numbers of children suffer diseases like measles and whooping cough as a result.

Q: There's been quite a bit of controversy surrounding Jenny McCarthy joining "The View." Do you think it's dangerous to give her such a platform?

A: Frankly, I don't think people pay much attention to Jenny McCarthy. In some ways the move away from vaccines by some people isn't surprising. We ask parents in this country to give vaccines to prevent 14 different diseases in the first few years of life. This can mean as many as 26 shots and 5 shots at one time to prevent diseases that most people don't ... understand. Jenny McCarthy or not, I think the movement by some away from vaccines is inevitable.